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Metal ring on a permanent molar: a rare occurrence
  1. Triveni N Nalawade1,
  2. Rachappa Mallikarjuna2,
  3. Gopika Sharma3,
  4. Kalyan Chakravarthy2
  1. 1Department of Pediatric and Preventive Dentistry, Anubhai Patel Dental College and Hospital, ORI, Vadodara, Gujarat, India
  2. 2Department of Pedodontics and Preventive Dentistry, K.M. Shah Dental College and Hospital, Vadoadara, Gujarat, India
  3. 3Department of Pedodontics and Preventive Dentistry, Jodhpur Dental College, Jodhpur, Rajasthan, India
  1. Correspondence to Dr Rachappa Mallikarjuna, mmrachappa{at}gmail.com
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http://dx.doi.org/10.1136/bcr-2012-007750

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    Description

    Foreign bodies are commonly found in the oral cavity1 of children and are discovered by dentist during the routine examination.2 An 11-year-old boy with parent reported with a rare chief complaint of a metal ring getting stuck on to the tooth from past 5 days. On interviewing the child and parent it was revealed that the child was playing with the metal ring and during the play unknowingly the child had put the ring into the mouth and the ring got stuck. The parent tried to remove the ring but without success. The parent was a motor garage owner and it was confirmed that the source of the metal ring was from the motor garage.

    On examination, a metal ring was found to be on the mandibular left first permanent molar (figure 1).

    Figure 1
    Figure 1

    Metal ring on left mandibular first molar.

    The buccal gingiva of mandibular left first permanent molar was found injured which clearly shows that an attempt had been made to remove the metal ring (figure 2).

    Figure 2
    Figure 2

    Injured buccal gingiva of left mandibular first molar.

    The treatment was explained to the patient and parent and the metal ring was removed using a band remover, which is routinely used in paediatric dentistry and orthodontics.

    On removing the metal ring, gingiva surrounding the mandibular left first permanent molar was found to be inflamed due to the pressure by the metal ring and food accumulation between the tooth and the metal ring (figure 3). Removed metal ring was measured 1 mm in thickness and 12 mm in diameter (figure 4).

    Figure 3
    Figure 3

    Inflamed gingiva due to the pressure by metal ring and food accumulation.

    Health professionals should be alert to the presence of foreign bodies, and educational campaigns should be conducted for emphasising the dangers of improper use of teeth.3

    Learning points

    • Dental surgeons should be alert to the presence of foreign bodies and their complications in the oral cavity of children.

    • Children and parents should be educated about dangers of improper use of teeth.

    • Parents should be educated so that very small objects are kept out of reach of children.

    References

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      1. Ram D,
      2. Peretz B
      . Tongue piercing and insertion of metal studs: three cases of dental and oral consequences. ASDC J Dent Child 2000;67:326–9.
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    2. ↵
      1. Yassin OM,
      2. Hattab FN
      . Unusual nasal foreign body detected on routine dental radiography: case report. J Clin Pediatr Dent 1996;20:155–7.
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    3. ↵
      1. Pomarico L,
      2. Primo LG,
      3. de Souza IP
      . Unusual foreign body detected on routine dental radiograph. Arch Dis Child 2005;90:825.
      OpenUrlFREE Full Text
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    Footnotes

    • Competing interests None.

    • Patient consent Obtained.

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    2012 BMJ Publishing Group Ltd